Then, last week, the U.S. Department of Health and Human Services sought
to delay another key deadline, the date by which consumers have to pay
their first month’s premium. As it stood, payments had to be received before
coverage began (so, by Dec. 31), but HHS asked insurers to be flexible.

HHS hinted last week that the
enrollment deadline was still not set in stone. “We will consider moving this
deadline to a later date should exceptional circumstances pose barriers to
consumers enrolling on or before December 23.” The department’s
fact sheet did not define “exceptional circumstances.”

The confusion only builds. The federal government sets enrollment deadlines
for the 36 states for which it handles sign-ups; the 14 state-based insurance
marketplaces set their own deadlines. Read these couple paragraphs
from a story by Jeffrey Young at The
Huffington Post:

The final date to choose a health plan that will be in place on Jan. 1 is
Dec. 23 in 46 states and the District of Columbia. Marylanders and Oregonians
have until Dec. 27, although Oregon residents had only until Dec. 4 to file paper
applications with the state exchange because online enrollment remains
unavailable.

The deadline to pay January premiums is now Jan. 10 in the 36 states served
by the federal exchanges and in Colorado and New York. Users of the exchanges
in Massachusetts, Minnesota and Nevada have to pay by Dec. 23. The due date is
Jan. 1 for Kentuckians, Jan. 6 for Rhode Islanders, Jan. 7 for Vermonters and
Jan. 15 for Marylanders. In the District of Columbia, Aetna customers have
until Jan. 8, while CareFirst BlueCross BlueShield and Kaiser Permanente
enrollees can pay up until Jan. 15. Hawaii and Oregon are still determining their
respective payment deadlines.

Here’s an excerpt from Wednesday’s Seattle
Times about Washington’s deadlines:

Washington residents who have started but not finished their applications
for insurance through the state's new health care exchange are getting a
deadline reprieve, state officials announced Wednesday.

Anyone who begins an application before the previous deadline of Dec. 23,
will get as much help as they need to finish and won't face a real deadline
until Jan. 15, said Michael Marchand, spokesman for
the Washington Health Benefit Exchange.

"The most important thing I want people to do is to take the action to
get that application started. We can work with them at that point," Marchand said Wednesday.

All of those dates could still change, so if you are in need of coverage,
it's best to ask questions early and often.

"There is massive confusion around deadlines," Mike Perry,
co-founder of research firm PerryUndem, recently
told The Washington Post. He has traveled the country doing focus groups
with uninsured Americans this past month. "March comes up. January is
prominent. But nobody seems to know the deadlines," Perry said.

If you don’t need coverage that begins Jan. 1, you’re in luck. The 2014 open
enrollment period for the health insurance marketplaces runs through March 31,
although your coverage generally won’t begin until the month after you sign up.
(Most consumers who go without insurance in 2014 will have to pay a penalty.)

In the next few days, as enrollment surges ahead of Monday’s “deadline,”
we'll begin to understand the scope of the problem. Covered California on
Wednesday said that 15,000
people a day are signing up for coverage; in New York, the figure is 4,500.

I’ve heard from a number of consumers this week saying that they had not yet
received invoices from their insurance companies, and so they have been unable
to pay their first month’s premiums. Along the same lines, at a forum for
health journalists last week, an official from the Community Service Society of
New York said that she was told that three prominent insurance companies were
only beginning to send out invoices to their enrollees.

As
I reported last week, some insurers reported that only 5 percent to 15
percent of enrollees had paid their first month’s premium.

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